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The Harrington reconstruction for advanced periacetabular metastatic destruction: Good outcome in 32 patients
Authors:Johan Nilsson  Pelle Gustafson  Per Fornander  Ewald Ornstein
Affiliation:1. Departments of Orthopedics, 1University Hospital, SE-221 85 Lund, Sweden. Tel +46 4617 10 00. E-mail: johan.nilsson@ort.lu.se;2. 2Hassleholm-Kristianstad Hospital, Hassleholm, Sweden
Abstract:We report the outcome in 32 patients operated on for advanced periacetabular metastatic destruction, where all but 2 had Harrington class III destruction. The patients were operated on using the Harrington reconstruction technique, where threaded pins and cement and a total hip replacement are used to reconstruct the acetabulum and ilium. The median survival was 11 (0-106+) months. 13 patients lived for a year or more. At follow-up after 1 year, 10 of the 13 were free of pain at rest and weight-bearing, 6 were walking with and 7 without support, and 11 lived outside a health care facility. 2 patients died within 2 weeks of surgery, both of excessive peroperative bleeding. 2 patients had dislocations, 1 developed a deep infection, and 2 patients deep vein thrombosis. There were no complications caused by erroneous pin placement or intraoperative thromboembolic incidents. There were no mechanical failures, or radiographic signs of loosening, of the pelvic components. The Harrington reconstruction technique is an effective and long-lasting method to relieve pain and restore function in patients with advanced periacetabular metastatic destruction.
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